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Osteoarthritis


Osteoarthritis or degenerative arthritis, affects one or more joints by the breakdown and loss of cartilage. Cartilage is the white, flexible material that acts as a cushion between the bones of a joint. Osteoarthritis is the most common type of arthritis, occurring more frequently as we age. Osteoarthritis can affect joints anywhere in the body but most commonly affecting the spine, hands, feet, knees and hips. Usually, large, weight bearing joints will be affected due to the pressure put on the cartilage by the heavy use and weight.

There are two categories that osteoarthritis is divided into, primary and secondary. Primary osteoarthritis is used when there is no known cause for the degeneration, except due to aging. Secondary osteoarthritis is used when there is a known cause for the breakdown of the cartilage caused by another condition or disease.

Secondary osteoarthritis can be caused by repeated trauma or surgery to the joint, obesity, gout, diabetes, or abnormal joints at birth called congenital abnormalities. Next to natural cartilage degeneration caused by aging, obesity is the number one risk factor for osteoarthritis. Obesity increases the mechanical stress of the joint because of the extra weight put on the joints. Congenital abnormalities lead to osteoarthritis, particularly of the hip joints, because of the vulnerability for mechanical wear, causing the early loss of cartilage.



Primary osteoarthritis is related to aging; as we age the cartilage proteins degenerate and the water content of the joint increases. With use over the years the cartilage becomes irritated and inflamed, leading to swelling and joint pain. Inflammation cartilage in the joints can cause bone spurs or bony growths to form around the joints, causing more joint pain and can interfere with the nerves.

Osteoarthritis does not affect other organs in the body, unlike rheumatoid arthritis or systematic lupus, but simply put it is solely a disease of the joints. Symptoms of osteoarthritis very from patient to patient with the most common being joint pain after repeated use, pain worsening later in the day, swelling, and creaking of the affected joints. After long periods of inactivity there can be pain and stiffness, such as after sleeping or sitting for an extended period of time. If osteoarthritis becomes severe and there is a total loss of cartilage in the joint, eliminating cushion and causing the bones to rub together, there can be pain even while resting and restricted movement.

Osteoarthritis of the spine can cause severe pain in the neck or lower back. Numbness, pain and tingling can be felt in other parts of the body like the legs or buttocks due to the bone spurs that grow along the spine, causing inflammation to the spinal nerves.

As of right now there is no specific treatment used to stop the degeneration of cartilage due to osteoarthritis. The best treatment to reduce the rate at which the cartilage is decreasing is weight reduction and avoiding certain activities that cause strain on the affected joints. The goal of treatment for osteoarthritis is to slow the rate of cartilage degeneration and reduce joint inflammation and pain, but still retaining joint functions.

Weight reduction can play a huge part in relieving symptoms of osteoarthritis, especially in the knee or hip joints, even a small reduction in weight significantly affects the joint pain and function. Medications are used in addition to weight reduction, rest, exercise, physical therapy and support devices. Osteoarthritis medications can be injected into the joints to immediately reduce inflammation (such as cortisone), topically (capsaicin or bengay)or orally (aspirin or acetaminophen). If the less invasive methods of treatment do not help joint pain, surgery may be considered by a health care professional.

Surgery for osteoarthritis is determined on a case to case basis since there are many different surgical options. Total joint replacement surgery or arthroplasty, replaces the affected joint with a artificial one. Arthroplasty requires rest and physical therapy following surgery. An osteotomy surgery removes bone from the joint that is affected with osteoarthritis to realign the joint and cause less wear on the cartilage. In some cases, the spine being the main area of treatment, fusion surgery will be performed on severely degenerated cartilage and joints. Fusion surgery fuses two bones together using a bone graph, creating one long bone that has no motion, therefore causing no pressure on the cartilage.

Since there is no permanent fix for osteoarthritis, the goal of treatment is to maintain or improve current joint function, while reducing joint pain and inflammation.
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